The truth about single-payer healthcare

Hello. Dr. Keith Smith with you – Surgery Center of Oklahoma. Thank you for joining me in this series.

I’d like to talk a little bit about what single-payer healthcare would look like in the United States. Some of the most vicious comments I’ve ever received from this series come from my comments about single-payer in other countries. Many people in the United States are fans of it, but that’s primarily because they do not understand what a disaster it truly is and how the countries all over the world that supposedly love their healthcare systems are morphing much more toward private efforts.

Privatization of healthcare in countries that have single-payer healthcare is ongoing and vigorous. Of course the Canadians have a private healthcare system at their disposal and that’s the very dysfunctional one here in the United States.

Single-payer healthcare in the United States would not look like it does in many of these foreign countries. I argue that it would be worse because it would be run just like Medicare is run. Medicare is not run, after all, by the government. Medicare is run by private contractors, typically giant insurance companies.

Indeed, single-payer in the United States would very likely look something like this: the country would be carved up into regions and the giant healthcare companies would vie or bid for the complete control of that region of the country.

The premiums that those companies receive would no longer be dependent on the satisfaction or dissatisfaction of the buyer or the consumer. They would plug directly into the taxpayer trough. They would take this money and determine what their profits needed to be at the end of the year and they would ration care accordingly to make sure their stock prices remained where they needed to be.

This will be enraging to many of you who are big fans of single-payer healthcare, but in the United States it will not take the form that it has in Canada even though in the Canadian system many of those people come to the United States for their care and there are vigorous privatization efforts there because it just simply doesn’t work. Socialism doesn’t work. It doesn’t work in healthcare.

The good news is here at the Surgery Center of Oklahoma, we’re showing how the free market can work. It’s bringing prices down and quality is increasing… not just in this region of the country, but all over the country by those who are embracing the discipline of the free market and giving no credence to any ideas that socialism in healthcare works at all.